What is Acne? Ask Dr. Brian Evans MD

Around three-quarters of all teenagers and young adults suffer from acne. However, men and women in their 30s and 40s can also suffer.

The exact cause of acne remains unclear but more is known about how the spots that are part of acne form. And there are more and more treatments to help deal with this distressing condition.

Dr. Brian Evans is a plastic surgeon in West Hills, California and is affiliated with multiple hospitals in the area, including Cincinnati Veterans Affairs Medical Center and San Joaquin Community Hospital. Consult him for all your cosmetic queries:


The causes of acne

Acne is a skin condition caused by over activity of the glands that secrete oily substances on to the skin. The blackheads and spots usually occur on the face, where the greatest number of these oil-producing “sebaceous” glands exist. The back, chest and shoulders can also be affected.



Acne Myth

Acne Fact

  1. Acne is curable: There is no cure for acne. However, through the consistent use of treatment and remedies acne can be controlled or prevented.
  2. Sun is great for acne: Sun may temporarily mask your acne, tighten up pores, or dry up the oil glands. However, the sun will also damage your follicular walls clogging your pores. Resulting in more acne that may not surface for 3-4 weeks after your sun exposure
  3. Washing your face more often will help clear up acne: Facial blemishes are not caused by dirt. Contrary to what you may have seen in commercials, pores do not get blocked from the top down. Rather, an entire pore collapses from deep within the skin, starting acne formation. Frequent washing does nothing to prevent this. Over-washing is actually irritating, and excess irritation can worsen acne. A washcloth can aggravate this situation further. Use bare hands to wash and only wash twice a day.
  4. Pizza, chocolate, and other junk food make me break out: Does chocolate really make you breakout with acne? What about oily foods? Prevailing wisdom in the dermatology community is that diet and acne are not related. Of course science is never a 100% reliable enterprise. But at this time, there is no evidence that chocolate, sugar, oil, milk, seafood, or any other food causes acne. Some people absolutely insist that a certain food causes acne for them, or that a specific acne diet works for them. In this case, doctors sometimes recommend that they avoid that food or follow that diet. Regarding chocolate specifically, several studies have been performed, and the answer to “does chocolate cause pimples?” is a resounding “No”.


Acne Facts

  1. Bacteria are common culprit to all forms of acne.
  2. Hey, you’re not alone, an estimated 80% of people suffer from some form of acne in their life
  3. Did you know there are many varieties of acne? In fact, there are over fifty types of acne. However, the most common form is acne vulgaris.
  4. Although many individuals believe the sun makes their acne better, the reality is ultraviolet rays that penetrate the skin’s surface can damage the follicles, closing them off and triggering acne two to four weeks after sun exposure.
  5. It takes three to four weeks for a pimple to form; therefore, what you ate yesterday does not affect your skin. Hormones and your genes are the main causes of acne.
  6. Spot-treating of acne does NOT work. The entire face and involved area must be treated daily in order to prevent new acne lesions.
  7. Acne is not curable. It is very treatable. The sooner you begin an individualized treatment program, the faster you have great-looking skin.
  8. Most people do NOT outgrow their acne. This, like any other disease, must be treated. You should not ignore this condition.
  9. Scrubbing and vigorous washing make acne WORSE. Loofah sponges, Buff Puffs, scrubs containing particles, and strips applied to the skin are all irritating and make acne worse.
  10. To remove all of the oil produced by your body, you would have to wash your face every minute. Excessive washing actually causes the body to produce more oil which makes acne worse.
  11. Stress does not cause acne, but can certainly make it worse. Stress often aggravates hormones, which may promote the process of producing new acne lesions.
  12. Diet does not contribute to acne in most individuals. Certain foods may cause flare-ups of acne.
  13. Acne breakouts are NOT caused by dirt clogging the pores. Acne is caused by hormones stimulating the oil glands, plugging of the pores by dead skin cells, bacteria living in the pores breaking down the oil and causing inflammation.


Acne and Basic Hygiene Practices for Beautiful Skin Care

Dirt does not cause acne. That is one of the very basic concepts that most acne sufferers need to accept. Keeping the face clean will help to make acne outbreaks happen less frequently and be less severe when they do happen but the fact that your face gets dirty is not the cause of acne.


Facial cleansing is particularly important for those who are generally prone to acne, however. The facial cleansing for the prevention of acne outbreaks and while an outbreak is in progress needs to be in a specific fashion.


  1. Wash your hands first. Is that surprising? It shouldn’t be. Your hands are about to come in contact with your face. The first thing you need to do is scrub your hands and be sure that your nails are clean as well.
  2. The next thing that you need to do is to secure your hair either in a hairnet, a shower cap or a headband. Pull your hair away from your face and firmly secure it.
  3. Wet your face with warm (not hot) water and apply the soap or facial cleansing product as directed on the packaging. Never use more or less of the product than is recommended.
  4. Using only your fingertips (NOT a washcloth), gently massage the cleanser into your face. Use a circular motion and be sure that you go all the way to the hairline. Pay particular attention to the areas of your face where you most often see pimple. Hard scrubbing is counterproductive. Be very gentle.
  5. Rinse your face thoroughly by splashing it with warm water. Dont take a shortcut here. Rinse your face until all traces of the cleanser are gone.
  6. Gently pat your face dry with a clean towel. Dont rub your face and never use a towel more than once.
  7. Allow your face to air dry for at least 15 minutes before you apply acne medications

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